August 11, 2015 - Microcytic and Microcytic Anemia Flashcards Preview

COURSE 1 > August 11, 2015 - Microcytic and Microcytic Anemia > Flashcards

Flashcards in August 11, 2015 - Microcytic and Microcytic Anemia Deck (24):
1

Location of Folate Absorption

Only in the jejunum.

2

Location of Cobalamin/B12 Absorption

Only in the ileum.

3

Location of Mg2+ Absorption

Only in the ileum.

4

Ferritin

A protein that binds to and stores iron. It can be tested in a blood sample.

5

Haemosiderin

The gold standard for determining iron levels in a patient, however it is only assessed by staining bone marrow with Prussian Blue and is therefore almost never used. Ferritin gives a good estimate and is significantly less invasive.

6

Location of Iron Absorption

Mainly in the duodenum.

7

Competitors for Iron Absorption

Include lead, cobalt, strontium, manganese, and zinc. These will out-compete iron and lead to poisoning of the individual.

8

Facilitators of Iron Absoription

Ascorbate, citrate, amino acids, and iron deficiency will increase the amount of absorption.

9

Causes for Iron Deficiency

1. Decreased iron intake (vegetarians)

2. Decreased iron absorption (celiac disease, Crohn's disease etc.)

3. Increased iron loss (chronic bleeding)

4. Increased iron requirements (pregnancy / lactation)

10

How much daily blood loss does it take to become iron deficient?

10 mL

11

Symptoms of Iron Deficiency

Asymptomatic

Pallor

Irritability

Exercise intolerance

Fatigue

Tachycardia

Koilonychia (spoon nails)

Blue sclera

12

Ferritin Test

The best screening test for iron deficiency anemia (not as invasive as haemosiderin). Low ferritin says iron deficient, although ferritin results may appear high in an acute inflammation.

13

Treatment for Iron Deficiency

Oral iron. Start slow as to avoid constipation, nausea, and stomache cramps.

IM iron. Painful, but can deliver large doses.

IV iron. Needs to be done in hospital, takes many hours, and may cause serum sickness, fever, headache, or anaphylaxis.

14

Other Causes of Microcytic Anemia

Thalassemia (problems with hemoglobin production)

Lead poisoning (rare)

ACD

15

Over 50 and Anemic

You must rule out colorectal cancer before anything else.

16

Causes of Folate Deficiency

Nutritional deficiency

Malabsorption

Drugs

Increased requirements

17

Folate Deficiency

Can cause macrocytic and megaloblastic anemia.

18

Folate Deficiency Diagnosis

Order a serum folate test.

Order a red blood cell folate test.

19

Treatment of Folate Deficiency

Oral folate.

20

Alcohol and Folate Absorption

Alcohol inhibits folate absorption.

21

B12 Storage Capacity

Your body stores enough B12 for years. This can be a problem with people going onto vegan diets as it will appear years later.

22

Homocysteine and Methylmalonic Acid Test

Confirmatory tests with borderline B12 test results.

23

Diagnosis of B12 Deficiency

Order a vitamin B12 serum test.

24

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